Also available as PDF (figures and tables appear in the PDF).
Coronavirus disease 2019 (COVID-19) has contributed to some unintended, yet valuable, reframing of advance care planning (ACP). Rather than perceiving ACP as merely being about death and dying, many healthcare providers and community members now acknowledge the need to plan in advance for healthcare decisions, especially if we are unable to communicate and consent for ourselves.
Open Journal PUBLISHERS Opinion The Reframing of Advance Care Planning: How Coronavirus Disease 2019 has Encouraged Us to Reflect More on our Values * Andrew Saunderson, RSW* 504-3292 Production Way, Burnaby, BC V5A 4R4, Canada * *Corresponding author Andrew Saunderson, RSW 504-3292 Production Way, Burnaby, BC V5A 4R4, Canada; E-mail: Andrew.Saunderson@fraserhealth.ca Article information th th th Received: August 18 , 2020; Accepted: September 7 , 2020; Published: September 10 , 2020 Cite this article Saunderson A. The reframing of advance care planning: How coronavirus disease 2019 has encouraged us to reflect more on our values. Palliat Med Hosp Care Open J. 2020; 6(1): 14. doi: 10.17140/PMHCOJ-6-136 oronavirus disease 2019 (COVID-19) has contributed to some Reflecting on and naming our values can often be chal- unintended, yet valuable, reframing of advance care planning lenging as values seem far too abstract to identify at times. How- C (ACP). Rather than perceiving ACP as merely being about death ever, medical professionals who actively practice ACP have con- and dying, many healthcare providers and community members sistently observed how a few simple questions can help easily now acknowledge the need to plan in advance for healthcare deci- discover and record a person’s values. These include asking: What sions, especially if we are unable to communicate and consent for does a good day look like? What brings your life meaning and pur- ourselves. Rather than perceiving ACP conversations as “difficult pose? And what brings you joy? These questions often turn into an conversations”, many healthcare providers and community members unexpected, yet valuable, joy list that highlights the things, people, now acknowledge them as important and essential conversations. places, and beliefs that are most important to us and bring meaning And rather than perceiving that ACP is primarily for the elderly or and happiness into our lives. A joy list whether short or long, is a gift seriously ill, many healthcare providers and community members to patients, healthcare providers, and substitute decision makers/ now acknowledge that we are all mortal and could unexpectedly health proxies, as it helps to ensure that the healthcare decisions become sick or injured; therefore, ACP is of value for all. made align with who you are and how you want to live. Joy lists and the prioritizing of your values, reminds the healthcare system that As Sudore et al1 concluded, “Advance care planning is a pro- quality of life is equally important as quantity of life. cess that supports adults at any age or stage of health”. And the primary goal of ACP is “to help ensure that people receive medical care that is con- While COVID-19 has turned so much of our world up- sistent with their values, goals and preferences”.1 Due to discomfort with side down, it has simultaneously provided a unique opportunity uncertainty and craving to feel some sense of control, particularly for all of us to reflect a little more on our values, as we more in- during times of crisis, many people presume that ACP is about tentionally consider what brings our life meaning and what brings considering and choosing specific medical treatments in advance. us joy. Taking time to reflect on, record, and share our values is And yet, at the core of ACP is in fact values. Our values dictate an imperative part of ACP. During a time when so many things most, if not all, of our choices and actions. Whether conscious or feel uncertain and out of our control, ACP provides an invaluable unconscious, our values influence what we wear, who we spend sense of control over our health and future.
time with, what we eat, where we travel, what we listen to and watch, and what activities we engage in or events we attend. Simi-